Find 2020 Medicare Plans in New Jersey - NJ Medicare Insurance Overview

Medicare Insurance in New Jersey

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New Jersey Medicare Insurance

New Jersey Medical Insurance Stats

Medicare in New Jersey

Medicare offers healthcare coverage to New Jersey residents age 65 or older, or to those New Jersey residents that suffer from certain medical disabilities. In 2016, 1,450,000 people are enrolled in Medicare in New Jersey, accounting for 16.4% of the population in New Jersey. About $11,903 was spent per Medicare enrollee in New Jersey in 2009, approximately 14.84% higher than the national average of $10,365 and the highest amount spent on each beneficiary out of all 50 states and Washington, D.C. From 2015 to 2030 the senior population in New Jersey is projected to increase by an estimated 41.47% according to calculations based off of the 2000 Census. Thus the number of Medicare beneficiaries in New Jersey is also expected to increase.

Local Medicare Resources

Medicare beneficiaries and their caretakers can receive free, personal, unbiased counseling regarding any questions they have about benefits, claims, supplement policies, and long-term care insurance. Counseling is funded by New Jersey’s State Health Insurance Assistance Program (SHIP). Furthermore, New Jersey participates in a national Senior Medicare Patrol (SMP) program which aims to educate individuals on how to detect, avoid, and report instances of Medicare waste, fraud, and/or abuse.

Types of Medicare Coverage

When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). Keep in mind that you must be eligible for Original Medicare in order to enroll in a Medicare Advantage plan. If you enroll in Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Many Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.

New Jersey 2017 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2017 Medicare Advantage plan in New Jersey is $70.78, 13.28% greater than the national average of $62.48. 31.47% of 2017 Medicare Part C insurance plans in New Jersey have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $400, but in New Jersey the average annual drug deductible for Medicare Part C insurance plans with drug components is $215.21. 27.89% of 2017 Medicare Part C insurance plans with a drug component in New Jersey have a $0 annual drug deductible.
  • The average total monthly premium for a 2017 Medicare Advantage plan without a drug component in New Jersey is $14.74. 78.57% of 2017 Medicare Part C insurance plans without a drug component in New Jersey have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in New Jersey is $6,312.5. 6.03% of 2017 Medicare Advantage plans in New Jersey had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in New Jersey was 3.8 stars in 2017.
  • Among New Jersey's 2017 Medicare Advantage plans with CMS star ratings:
    • 2.59% earned a score of 5 stars
    • 55.17% earned a score of 4 or 4.5 stars
    • 31.03% earned a score of 3 or 3.5 stars
    • 1.72% earned a score of 2 or 2.5 stars
    • 9.48% of plans are “Not enough data available” or “Too new to be measured”.

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

There are 17 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in New Jersey. Of these, the companies that offer the largest variety of plans to choose from are Aetna, Humana, and UnitedHealthcare. In New Jersey,Oxford has the largest selection of Medicare Advantage plans while UnitedHealthcare offers the most Medicare Part D plans. The following are all medicare insurance providers in New Jersey:

Aetna

16 Plans

Humana

13 Plans

Mutual of Omaha Rx

2 Plans

MII Life Insurance, Incorporated

2 Plans

EnvisionInsurance

2 Plans

EmblemHealth Medicare PDP

2 Plans

Clear Spring Health

2 Plans

Amerigroup

2 Plans

Medicare Rx (PDP)

1 Plans

Erickson Advantage Liberty without Drugs (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
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Aetna Medicare Core Value (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
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HumanaChoice H5216-174 (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
AARP Medicare Advantage Essential (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
HumanaChoice H5216-183 (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Aetna Medicare Credit Value (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Aetna Medicare Explorer Elite (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Amerivantage Classic (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Cigna-HealthSpring Preferred (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Clover Health Choice (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Horizon Medicare Blue Choice w/Rx (HMO)
TYPE:HMOCOST:from $196CMS Rating:Not Rated
Select
Erickson Advantage Signature with Drugs (HMO-POS)
TYPE:HMO-POSCOST:from $195CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier Plus (HMO)
TYPE:HMOCOST:from $174CMS Rating:Not Rated
Select
Horizon Medicare Blue (PPO)
TYPE:PPOCOST:from $161CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier 2 (PPO)
TYPE:PPOCOST:from $104CMS Rating:Not Rated
Select
Horizon Medicare Blue Choice w/Rx (HMO)
TYPE:HMOCOST:from $196CMS Rating:Not Rated
Select
Erickson Advantage Signature with Drugs (HMO-POS)
TYPE:HMO-POSCOST:from $195CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier Plus (HMO)
TYPE:HMOCOST:from $174CMS Rating:Not Rated
Select
Horizon Medicare Blue (PPO)
TYPE:PPOCOST:from $161CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier 2 (PPO)
TYPE:PPOCOST:from $104CMS Rating:Not Rated
Select
Horizon Medicare Blue Choice w/Rx (HMO)
TYPE:HMOCOST:from $196CMS Rating:Not Rated
Select
Erickson Advantage Signature with Drugs (HMO-POS)
TYPE:HMO-POSCOST:from $195CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier Plus (HMO)
TYPE:HMOCOST:from $174CMS Rating:Not Rated
Select
Horizon Medicare Blue (PPO)
TYPE:PPOCOST:from $161CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier 2 (PPO)
TYPE:PPOCOST:from $104CMS Rating:Not Rated
Select
Horizon Medicare Blue Choice w/Rx (HMO)
TYPE:HMOCOST:from $196CMS Rating:Not Rated
Select
Erickson Advantage Signature with Drugs (HMO-POS)
TYPE:HMO-POSCOST:from $195CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier Plus (HMO)
TYPE:HMOCOST:from $174CMS Rating:Not Rated
Select
Horizon Medicare Blue (PPO)
TYPE:PPOCOST:from $161CMS Rating:Not Rated
Select
Aetna Medicare Explorer Premier 2 (PPO)
TYPE:PPOCOST:from $104CMS Rating:Not Rated
Select

The following are the most popular medicare doctors in New Jersey based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
RadiologyNEW BRUNSWICK, NJ
RadiologyMAYS LANDING, NJ
RadiologyMOUNT LAUREL, NJ
RadiologyGALLOWAY, NJ
PathologyFLORHAM PARK, NJ
DermatologyWESTFIELD, NJ
RadiologyEWING, NJ
RadiologyUNION, NJ
OphthalmologyISELIN, NJ
Internal MedicineUNION, NJ

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).